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BREANA CHRISTINE CUMMENS MD
NPI 1376961086
Family Medicine in Greenfield, WI

Active since March 31, 2014PECOS EnrolledAccepts Medicare Assignment
82.39/100
CMS Quality Rating
4935 S. 76TH ST., SUITE 101, GREENFIELD, WI 53220(414) 777-3100(525) 260-7345 Get Directions Write a Review

NPPES record last updated: November 26, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 26, 2021, Mar 17, 2018, Aug 4, 2017 (3 updates tracked since 2017).

About Breana Christine Cummens Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BREANA CHRISTINE CUMMENS MD (NPI 1376961086) is an individual family medicine provider in Greenfield, Wisconsin, licensed in Wisconsin (64724-20) and active in the NPI registry since March 2014. She is enrolled in Medicare PECOS, is affiliated with Ascension Columbia St Mary's Hospital Milwaukee, and is a graduate of Medical College Of Wisconsin (2014).

NPPES Registry Identity

NPI1376961086
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameBREANA CHRISTINE CUMMENSCredential: MD
Location Address4935 S. 76TH ST., SUITE 101Greenfield, WI 53220
Mailing Address4935 S. 76th St., Suite 101Greenfield, WI 53220 · (414) 777-3100 · Fax (525) 260-7345
Phone(414) 777-3100
Fax(525) 260-7345
Sole ProprietorNo
Medical School CMSMedical College Of WisconsinGraduated 2014
Enumeration DateMarch 31, 2014
Last NPPES UpdateNovember 26, 20213 updates tracked since enumeration
NPPES CertifiedNovember 26, 2021
✔ NPI 1376961086 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 64724-20
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
4935 S. 76TH ST., Greenfield, WI 53220
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Breana Christine Cummens Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103136791
PECOS Enrollment IDI20170914001225
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
123 services87 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
92 services92 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
68 services60 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
27 services27 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
27 services27 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
25 services25 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension Columbia St Mary's Hospital Milwaukee

Acute Care Hospitals · Milwaukee, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520051
Location2323 N Lake DrMilwaukee, WI 53211 · Milwaukee County
Emergency services Birthing friendly

Ascension St Francis Hospital

Acute Care Hospitals · Milwaukee, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520078
Location3237 S 16th StMilwaukee, WI 53215 · Milwaukee County
Emergency services

Ascension SE Wisconsin Hospital

Acute Care Hospitals · Milwaukee, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520136
Location5000 W Chambers StMilwaukee, WI 53210 · Milwaukee County
Emergency services Birthing friendly

West Allis Memorial Hospital

Acute Care Hospitals · West Allis, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520139
Location8901 W Lincoln AveWest Allis, WI 53227 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53220 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

82.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.88
Promoting Interoperability81
Improvement Activities40
Cost74.38

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
11 suppliers38 claims77 services$5.63 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers22 claims30 services$0.97 avg. paid by Medicare
Ostomy pouch, closed, with barrier attached, with filter (1 piece), each A4416
DME-Orthotic Devices · category DF010N
1 supplier12 claims360 services$2.14 avg. paid by Medicare
Dynamic adjustable knee extension / flexion device, includes soft interface material E1810
DME-Other DME · category DE000N
1 supplier12 claims12 services$85.24 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
1 supplier11 claims1,650 services$0.03 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
1 supplier11 claims11 services$22.81 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Breana Cummens's NPI number?

The NPI number for Breana Cummens is 1376961086. It was assigned to this individual provider in the NPPES registry on March 31, 2014.

Where is Breana Cummens located?

Breana Cummens practices at 4935 S. 76th St. Suite 101, Greenfield, WI 53220. The listed phone number is (414) 777-3100.

What is Breana Cummens's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Breana Cummens enrolled in Medicare?

Yes. Breana Cummens is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Breana Cummens accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Breana Cummens as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Breana Cummens affiliated with any hospitals?

According to CMS data, Breana Cummens is affiliated with Ascension Columbia St Mary's Hospital Milwaukee, Ascension St Francis Hospital, Ascension SE Wisconsin Hospital and West Allis Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Breana Cummens was last updated on November 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.